NPI 1629745658

Jhonny D Grady

Practitioner Drama Therapist Milwaukee, WI

Practice location

Address: 5839 N Teutonia Ave, Milwaukee, WI 53209-4161
Phone: (917) 719-4698

Registered specialties

Drama Therapist Primary

Behavioral Health & Social Service Providers Taxonomy 101200000X Licence G6304246825900 (WI)

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Registry record

NPI: 1629745658
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 Aug 2021
Record last updated: 26 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.